The Coefficient of Variation of Red Blood Cell Distribution Width Combined with Cancer Antigen 125 Predicts Postoperative Overall Survival in Endometrial Cancer

Abstract

Purpose This study assessed the prognostic value of red blood cell distribution width (RDW) and cancer antigen 125 (CA125) in predicting the prognosis of endometrial cancer (EC) patients. Patients and Methods In this study, we included 525 patients with EC between January 2013 and January 2019. Demographic and clinical indicators were collected, and the receiver operating characteristics curve (ROC) and cutoff values were calculated between the early and advanced stages of EC. Independent risk factors associated with EC prognosis were assessed using Cox regression analyses and the Kaplan–Meier method. Results Compared to women in the early stage of EC, women with advanced stage had significantly elevated RDW coefficient of variation (RDW-CV) and CA125 levels and lower mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) (both P < 0.05). Consequently, RDW-CV and CA125 were found to be independent risk factors for EC by using ROC curve and multivariate logistic regression analysis. The survival analysis curve was used to assess the diagnostic value of RDW-CV, CA125, and their combination in the prognosis of EC. The results showed that patients with high expression of RDW-CV and CA125 had worse overall survival than those with low expression. Moreover, multivariate Cox regression analysis indicated that RDW-CV+CA125=2 was an independent prognostic factor. Conclusion These findings suggest that CA125 combined with RDW-CV has a good prognostic value for EC. Thus, the RDW-CV+CA125 score is a promising prognostic marker for the clinical decision-making process regarding EC outcomes.

Clinical Relevance of Red Blood Cell Distribution Width (RDW) in Endometrial Cancer: A Retrospective Single-Center Experience from Korea

“…These results revealed that RDW may play a pivotal role in predicting the survival of patients with endometrial cancer, particularly those with advanced disease. This is consistent with previous findings in patients with other malignancies, including breast, lung, and gynecologic cancers [13][14][15][16][17].…”

Preoperative Prediction Value of Pelvic Lymph Node Metastasis of Endometrial Cancer: Combining of ADC Value and Radiomics Features of the Primary Lesion and Clinical Parameters

“…In clinical practice, CA125 has been routinely used to diagnose a variety of malignancies, especially epithelial ovarian cancer [ 28 ]. Quan et al [ 29 ] demonstrated that serum CA125 significantly correlated with clinicopathological risk factors, such as depth of myometrial invasion, LN status, and FIGO stage and that CA125 is a promising prognostic indicator for EC [ 30 , 31 ]. In our study, CA125 could be used as an independent predictor of PLNM in EC patients, which is consistent with the results of Lei et al [ 32 ].…”

The predictive role of CA- 125 value in early stage endometrioid endometrial cancer

“…In a study by Unsal et al, which included 423 patients with EEC, it was found that high CA-125 levels were associated with tumor spread and lymph node metastasis; however, after adjusting for age, in patients >50 years, the CA-125 cutoff value for predicting lymph node metastasis was found to be 16 IU/L 23 Zhong et al found that the red cell distribution width coefficient of variation and CA-125 levels were significantly increased in the advanced stage compared to within the early stage of endometrial cancer, showing that these patients had worse overall survival 24 . Yilmaz Baran et al showed that choosing a CA-125 level of 16 IU/L may be more beneficial for early stage endometrial cancer with negative prognostic factors.…”